Robman, LD and Thao, LTP and Guymer, RH and Wolfe, R and Woods, RL and Hodgson, LA and Phung, J and Makeyeva, GA and Le-Pham, Y-A and Orchard, SG and Suleiman, J and Maguire, E and Trevaks, RE and Ward, SA and Riaz, M and Lacaze, P and Storey, E and Abhayaratna, WP and Nelson, MR and Ernst, ME and Reid, CM and McNeil, JJ, ASPREE Investigator Group, Baseline characteristics and age-related macular degeneration in participants of the 'ASPirin in Reducing Events in the Elderly' (ASPREE)-AMD trial, Contemporary Clinical Trials Communications, 20 Article 100667. ISSN 2451-8654 (2020) [Refereed Article]
Copyright 2020 The Authors. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) https://creativecommons.org/licenses/by-nc-nd/4.0/
Methods: Australian participants from the ASPirin in Reducing Events in the Elderly (ASPREE) trial, randomized to 100 mg aspirin daily or placebo, had non-mydriatic, digital color fundus images graded according to the Beckman AMD classification. Associations with AMD were determined for baseline characteristics and genetic risk variants.
Results: ASPREE-AMD sub-study enrolled 4993 participants with gradable macular images. Median age was 73.4 years (IQR, 71.5, 76.6), 52% were female, 10% had diabetes mellitus, 73% had hypertension, and 44% were former/current smokers. Early, intermediate and late AMD (detected in 20.6%, 16.1%, 1.1%, respectively), significantly associated with age, were also associated with increasing HDL levels: OR = 1.52 (95%CI, 1.26, 1.84), OR = 1.43 (1.17, 1.77) and OR = 1.96 (1.02, 3.76), respectively. Female sex was associated with early [OR = 1.37 (1.16, 1.62)], and intermediate [OR = 1.35 (1.12, 1.63)] AMD, as was previous regular use of aspirin, with OR = 1.46 (1.11, 1.92) and OR = 1.37 (1.01, 1.85), respectively. Current smoking had increased odds for late AMD, OR = 4.02 (1.42, 11.36). Genetic risk variant rs3750846 (ARMS2/HTRA1) was associated with each AMD stage (p < 0.001), risk variants rs570618 and rs10922109 (CFH) with intermediate and late AMD (p < 0.001), and rare variant rs147859257 (C3) with late AMD (p < 0.001). The randomized groups were well balanced for all analyzed AMD risk factors.
Conclusions: Observed associations are typical of AMD. The ASPREE-AMD clinical trial provides a unique opportunity to determine the risks and benefits of low-dose aspirin for AMD incidence and progression in elderly population.
|Item Type:||Refereed Article|
|Keywords:||AMD, age-related macular degeneration, aspirin, baseline characteristics, elderly, randomized controlled trial|
|Research Division:||Health Sciences|
|Research Group:||Public health|
|Research Field:||Preventative health care|
|Objective Group:||Specific population health (excl. Indigenous health)|
|Objective Field:||Health related to ageing|
|UTAS Author:||Nelson, MR (Professor Mark Nelson)|
|Web of Science® Times Cited:||1|
|Deposited By:||Menzies Institute for Medical Research|
|Downloads:||18 View Download Statistics|
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